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Innova&on	
  through	
  the	
  Lenses	
  
of	
  HITECH	
  and	
  Health	
  Reform	
  
	
  
	
  
Wil	
  Yu,	
  Innova&ons	
  
Wil.Yu@HHS.gov	
  
HHS  	
  
Innova&on	
  Goals	
  


  •  Encourage innovations that will be required to
     help enhance health and well being for all
     Americans

  •  New products, services, ideas
      –  Support Meaningful Use and health information Exchange
      –  Support health reform
      –  Support of ONC and HHS strategy and priorities




                                                                  2
Current	
  Context	
  for	
  Health	
  IT	
  Innova&on	
  

  •  Enacted legislation and current administration policies & rule-making
     have created new markets for health IT and healthcare
     (…and displaced old markets)

  •  Innovation will happen naturally in the marketplace whether or not
     we engage

  •  Innovation in the private sector cannot be sustained without
     pathways to true markets

  •  By encouraging and facilitating communication & collaboration, we
     can influence magnitude, timing, and velocity

  •  By encouraging and facilitating communication & collaboration, we
     can influence efficient deployment of resources – e.g. ideation, mkt.
     transparency, risk identification, search costs, etc.
                                                                             3
Recovery	
  Act	
  	
  /	
  HITECH	
  Programs	
  
  Obstacle                       Intervention                                             Funds Allocated

                                                •    Medicare and Medicaid EHR
  Market Failure, Need for
                                                     Incentive Programs for Meaningful    •    $27.3 B
  Financial Resources
                                                     Use

  Addressing Adoption                           •    Regional Extension Centers           •    $643 M
  Difficulties                                  •    Health IT Research/Resource Center   •    $50 M


  Workforce Training                            •    Workforce Training Programs          •    $84 M


                                                •    Strategic Health Information
  Addressing Technology                                                                   •    $60 M
                                                     Technology Advanced Research
  Challenges and Providing
                                                     Projects (SHARP)
  Breakthrough Examples                         •    Beacon Communities Programs          •    $250 M

                                                •    Policy Framework                     Addressed
  Privacy and Security                          •    New Privacy and Security Policies    across all
                                                                                          Programs

                                                •    NHIN, Standards and Certification    •    $64.3 M
  Need for Platform for Health
                                                •    State Cooperative Agreement          •    $548 M
  Information Exchange
                                                     Program

  *estimate
                                                                                                         4
How	
  it	
  all	
  fits	
  together	
  


    Regional Extension Centers
                                                         ADOPTION
        Workforce Training
                                                                                  Improved	
  Individual	
  &	
  
                                                                                    	
  Popula+on	
  Health	
  
                                                                                            Outcomes	
  
                                                                                                    	
  
       Medicare	
  and	
  Medicaid	
  	
                                                     Increased	
  
      Incen+ves	
  and	
  Penal+es	
                    MEANINGFUL USE                   Transparency	
  &	
  
                                                                                            	
  Efficiency	
  
                                                                                                    	
  
                                                                                             Improved	
  
                                                                                        Ability	
  to	
  Study	
  &	
  
         State Grants for                                                         Improve	
  Care	
  Delivery	
  
   Health Information Exchange

Standards & Certification Framework                      EXCHANGE	
  

   Privacy & Security Framework


                                             Health IT Research and Innovations
                                                                                                                  5
DC-­‐to-­‐VC	
  Engagements	
  


  •  Core Value: Promote engagements between
     diverse, but critical stakeholders necessary for
     early stage entrepreneurship and innovation

  •  Intense, bi-directional,
     communication

  •  In collaboration with
     White House Startup
     America Initiative

                                                        6
Prizes	
  and	
  Challenges	
  
Inves&ng	
  in	
  Innova&ons	
  (i2)	
  

  •  Core Value: Encourage open innovation and community building

  •  Context:
      –  America Competes 2010
      –  Alternative to Grants
      –  Alternative to Contracts


  •  Benefits:
      –  Engage new participants
      –  Community building


  •  2 years; 30+ challenges


                                                                    7
Innova&on	
  Exchanges	
  for	
  Health	
  IT	
  



  •  Core Value: Convene sessions between groups
     of innovators and potential adopters towards
     short-term testbed opportunities

  •  Help innovators reach proof-of-concept stage

  •  Provide care organizations with access to
     leading edge technologies

                                                    8
Suppor&ng	
  Early	
  Stages	
  of	
  	
  
Innova&ons:	
  A	
  Framework	
  




  Concept                      Proof of        Early      Optimize     Late
     +         Prototype       Concept        Adoption       +       Adoption
  Ideation                                                 Refine
                               Innovation risk and cost
high                                                                        low




                                                                                9
Suppor&ng	
  Early	
  Stages	
  of	
  	
  
Innova&ons:	
  A	
  Framework	
  

  Concept                            Proof of          Early        Optimize       Late
     +           Prototype           Concept          Adoption         +         Adoption
  Ideation                                                           Refine
                                     Innovation risk and cost
high                                                                                         low
                                                  Innovation Scanning
                                                 Innovations Exchange   Beacon Communities
                                 i2 - Prizes and Challenges
                                                                        HIE Challenge Grants
                                DC-to-VC

                                    Innovation Exchanges

                       S&I: Direct / NwHIN

                   SHARP


       CHDI / Health Data.gov

                                                                                             10
Innovation Center Activities	
  
The Innovation Center

Mission Statement
 Be a constructive and trustworthy partner in identifying,
  testing, and spreading new models of care and payment
  that continuously improve health and health care for all
  Americans.




                                                             12	
  
A Future System
•    Affordable
•    Accessible – to care and to information
•    Seamless and coordinated
•    High Quality – timely, equitable, safe
•    Person and Family-Centered
•    Supportive of Clinicians in serving their patients needs
•    Engaged with the community and ful lling its population s unique needs




                                                                              13	
  
 
                   Measures of Success

1.  Better health care - Improve individual patient experiences of care along
    the IOM 6 domains of quality: Safety, Effectiveness, Patient-Centeredness,
    Timeliness, Efficiency, and Equity
2.  Better health - Focus on the overall health outcomes of populations by
    addressing underlying causes of poor health, such as: physical inactivity,
    behavioral risk factors, lack of preventive care, and poor nutrition

3.  Reduced costs - Lower the total cost of care for Medicare, Medicaid and
    CHIP bene ciaries by improving quality of care and patient experience




                                                                                 14	
  
Innovation Center Menu of Options


                                                                                                                                              Global	
  
                                                                                                                            Pioneer	
  	
     Payment	
  
                                                                                                           ACO	
  –	
       ACOs	
  
                                                                                   ACO	
  –	
              Track	
  2	
  
                                                                                   Track	
  1	
  
                                                                                                  Medical	
  
                         	
                                                                       Homes	
  
                         	
  	
  	
  	
  	
  	
  Bundled	
  Payments	
  for	
  Care	
  	
  	
  	
  	
  
                         	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  Improvement	
  
                 Million	
  Hearts	
  
                 	
  
        Partnership	
  for	
  
        Pa&ents	
  
Meaningful	
  	
  
Use	
  
Innovation Center Initiatives to
          Support Care Transformation	
  
•    ACO Initiatives: Shared Savings Program,   •    Medicaid Health Home State Plan
     Pioneer, Advance Payment, Learning              Option
     Sessions
                                                •    State Demonstrations to Integrate
•    Bundled Payments for Care Improvement
                                                     Care for Dual Eligible Individuals
•    Innovation Advisors Program
                                                •    Demonstration to Improve Quality
•    Multi-Payer Advanced Primary Care               of Care for Nursing Facility
     Practice Demonstration                          Residents
•    Comprehensive Primary Care Initiative
                                                •    Financial Models to Support State
•    Partnership for Patients                        Efforts to Coordinate Care for
                                                     Medicare-Medicaid Enrollees
•    Federally Quali ed Health Center (FQHC)
     Advanced Primary Care Practice             •    Innovation Center Initiatives
     Demonstration
                                                     Support Care Transformation


                                                                                          16	
  
Accountable Care Organizations 	
  

•  Accountable Care Organizations (ACOs) are groups of doctors, hospitals,
   and other health care providers, who come together voluntarily to give
   coordinated high quality care to the Medicare patients they serve
•  Coordinated care helps ensure that patients, especially the chronically ill,
   get the right care at the right time, with the goal of avoiding unnecessary
   duplication of services and preventing medical errors
•  When an ACO succeeds in both delivering high-quality care and spending
   health care dollars more wisely, it will share in the savings it achieves for
   the Medicare program




                                                                                   17	
  
ACO Types	
  

•  Medicare offers several ACO programs, including:

•  Medicare Shared Savings Program—a fee-for-service program

•  Advance Payment Initiative—for certain eligible providers in the Shared
   Savings Program

•  Pioneer ACO Model— population-based payment initiative for health care
   organizations and providers already experienced in coordinating care for
   patients across care settings



                                                                              18	
  
Transforming Health Care Through
         Active Engagement	
  
•  No one organization or region has a monopoly on innovation

•  Innovators across the country have developed other effective care delivery
   and payment models


•  These innovations offer us pathways to building a future health system that
   is more effective than the current system at improving health care, health,
   and lowering costs




                                                                                19	
  
The Infrastructure Implications of
                 Accountable Care	
  

•  New IT infrastructure models will be required
    –  EMRs/Meaningful Use and health IT adoption
    –  Health information exchange and other


•  Address challenges of care coordination and risk management at an
   organizational level and across potentially diverse organizations

•  à Investments in data collection, integration, and analytics
    –  Population health management, cost analytics, risk modeling and predictive analytics


•  à Investments in patient engagement
    –  Personal health records


                                                                                              20	
  
Innovation Imperative	
  

•  Success of new models predicated on our ability to innovate

•  New markets are being created but there is a window for proof-of-concept

•  Magnitude and velocity of our ability to innovate will be critical to our
   ability to implement, learn, diffuse




                                                                               21	
  
Introducing the Health Care Innovation
               Challenge

•  The Innovation Center has received over 500 suggestions and ideas from
   across the country.


•  This initiative is an open solicitation to innovators across the country to
   identify and test innovative service delivery/payment models including
   infrastructure support.
•  This Challenge will strengthen the Innovation Center s current menu of
   options and will address unique needs of communities and populations
   across the country.




                                                                                 22	
  
Challenge Objectives


•  Engage a broad set of innovation partners to identify and test
   new care delivery and payment models that originate in the eld
   and improve quality while lowering the total cost of care.
•  Support innovators that can rapidly deploy care improvement
   models within six months of the award through new ventures or
   expansion of existing efforts.
•  Identify new models of workforce development, training and
   deployment that support new models either directly or through
   new infrastructure activities.


                                                                   23	
  
Challenge Area: Service/Payment Delivery
                      Model 	
  

•  $1 billion to fund innovative service delivery and payment models
   to support those innovative models
•  Successful proposals will
   –  De ne and test a clear pathway to sustainability
      (higher quality and lower total system cost)
   –  Demonstrate care improvement within six months of award
   –  Support care transformation with enhanced infrastructure activity
   –  Rapidly develop and deploy a health care workforce Proposals are encouraged to
      focus on high-cost/high-risk populations
   –  Including those with multiple chronic conditions, mental health or substance abuse
      issues, poor health status due to socioeconomic and environmental factors, or the frail
      elderly

                                                                                         24	
  
 
         Challenge Area: Infrastructure Support


•  New types of infrastructure will enable others to learn from
   and support more effective and efficient system-wide function
•  Enhancing infrastructure activity is critical to fully achieving
   better care, better health, and lower costs
•  Examples:
   –    Implementation of registries
   –    Medication reconciliation systems
   –    Shared-decision making systems
   –    Innovation or Improvement Networks
   –    Community collaboratives

                                                                      25	
  
 
             Challenge Area: Workforce Impact


•    Transforming our health system requires transformation of
     our health workforce
•    Need to identify and test new ways to create the workforce
     of the future that will deliver and support new care models.
•    Examples:
     –    New roles and skills for existing health professionals
     –    New types of workers to support care transformation
     –    Team-based models to better utilize a mix of health providers




                                                                          26	
  
Challenge Area: Speed to Implementation	
  


•    Proposed models should be operational and capable of
     rapid expansion or sufficiently developed to be rapidly
     deployed.
•    Proposals will be expected to deploy care improvement
     models within 6 months of the award.
•    Training programs are eligible for funding but should be
     intensive, brief programs connected to the model being
     tested.



                                                                27	
  
Challenge Area: Pathway to Sustainability	
  

•    Proposed models are expected to
     –     De ne and test a clear pathway to ongoing sustainability
     –     Inform future bene t design and/or payment approaches for CMS
           consideration and
     –     Provide recommendations for the scaling and diffusion of the proposed
           model
•    Preference will be given to proposals that can achieve sustainability as
     soon as possible within 3 years.
•    Examples of sustainability approaches:
     –     Public-private partnerships
     –     Multi-payer approaches
     –     Proposed service delivery agreements with entities such as ACOs or
           Advanced Primary Care models, mental health/public health
           systems
                                                                                  28	
  
Selection Criteria	
  


•  Model Design
•  Organizational Capacity
•  Workforce
•  Sustainability and Finances
•  Evaluation




                                           29	
  
Learning and Diffusion

•  The Innovation Center will identify and diffuse successful
   practices that achieve better health care, better health,
   and lower costs
•  Awardees will engage in shared learning activities
   designed to
   –  Bring organizations together to learn from one another
   –  Actively measure success
   –  Share breakthrough ideas to accelerate progress




                                                               30	
  
Eligible Applicants

•  Provider groups            •  Public-private partnerships
•  Health systems             •  Private sector organizations
•  Payers                     •  Faith-based organizations
•  Community-collaboratives
•  For-pro t organizations
•  Community-based
   organizations
•  Local governments

                                                                31	
  
Innovation through the lenses of
HITECH and Health Reform
Wil Yu
Director, Innovations
Wil.Yu@HHS.gov
HHS

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Innovation Through the Lenses of HITECH and Health Reform

  • 1. Innova&on  through  the  Lenses   of  HITECH  and  Health  Reform       Wil  Yu,  Innova&ons   Wil.Yu@HHS.gov   HHS  
  • 2. Innova&on  Goals   •  Encourage innovations that will be required to help enhance health and well being for all Americans •  New products, services, ideas –  Support Meaningful Use and health information Exchange –  Support health reform –  Support of ONC and HHS strategy and priorities 2
  • 3. Current  Context  for  Health  IT  Innova&on   •  Enacted legislation and current administration policies & rule-making have created new markets for health IT and healthcare (…and displaced old markets) •  Innovation will happen naturally in the marketplace whether or not we engage •  Innovation in the private sector cannot be sustained without pathways to true markets •  By encouraging and facilitating communication & collaboration, we can influence magnitude, timing, and velocity •  By encouraging and facilitating communication & collaboration, we can influence efficient deployment of resources – e.g. ideation, mkt. transparency, risk identification, search costs, etc. 3
  • 4. Recovery  Act    /  HITECH  Programs   Obstacle Intervention Funds Allocated •  Medicare and Medicaid EHR Market Failure, Need for Incentive Programs for Meaningful •  $27.3 B Financial Resources Use Addressing Adoption •  Regional Extension Centers •  $643 M Difficulties •  Health IT Research/Resource Center •  $50 M Workforce Training •  Workforce Training Programs •  $84 M •  Strategic Health Information Addressing Technology •  $60 M Technology Advanced Research Challenges and Providing Projects (SHARP) Breakthrough Examples •  Beacon Communities Programs •  $250 M •  Policy Framework Addressed Privacy and Security •  New Privacy and Security Policies across all Programs •  NHIN, Standards and Certification •  $64.3 M Need for Platform for Health •  State Cooperative Agreement •  $548 M Information Exchange Program *estimate 4
  • 5. How  it  all  fits  together   Regional Extension Centers ADOPTION Workforce Training Improved  Individual  &    Popula+on  Health   Outcomes     Medicare  and  Medicaid     Increased   Incen+ves  and  Penal+es   MEANINGFUL USE Transparency  &    Efficiency     Improved   Ability  to  Study  &   State Grants for Improve  Care  Delivery   Health Information Exchange Standards & Certification Framework EXCHANGE   Privacy & Security Framework Health IT Research and Innovations 5
  • 6. DC-­‐to-­‐VC  Engagements   •  Core Value: Promote engagements between diverse, but critical stakeholders necessary for early stage entrepreneurship and innovation •  Intense, bi-directional, communication •  In collaboration with White House Startup America Initiative 6
  • 7. Prizes  and  Challenges   Inves&ng  in  Innova&ons  (i2)   •  Core Value: Encourage open innovation and community building •  Context: –  America Competes 2010 –  Alternative to Grants –  Alternative to Contracts •  Benefits: –  Engage new participants –  Community building •  2 years; 30+ challenges 7
  • 8. Innova&on  Exchanges  for  Health  IT   •  Core Value: Convene sessions between groups of innovators and potential adopters towards short-term testbed opportunities •  Help innovators reach proof-of-concept stage •  Provide care organizations with access to leading edge technologies 8
  • 9. Suppor&ng  Early  Stages  of     Innova&ons:  A  Framework   Concept Proof of Early Optimize Late + Prototype Concept Adoption + Adoption Ideation Refine Innovation risk and cost high low 9
  • 10. Suppor&ng  Early  Stages  of     Innova&ons:  A  Framework   Concept Proof of Early Optimize Late + Prototype Concept Adoption + Adoption Ideation Refine Innovation risk and cost high low Innovation Scanning Innovations Exchange Beacon Communities i2 - Prizes and Challenges HIE Challenge Grants DC-to-VC Innovation Exchanges S&I: Direct / NwHIN SHARP CHDI / Health Data.gov 10
  • 12. The Innovation Center Mission Statement Be a constructive and trustworthy partner in identifying, testing, and spreading new models of care and payment that continuously improve health and health care for all Americans. 12  
  • 13. A Future System •  Affordable •  Accessible – to care and to information •  Seamless and coordinated •  High Quality – timely, equitable, safe •  Person and Family-Centered •  Supportive of Clinicians in serving their patients needs •  Engaged with the community and ful lling its population s unique needs 13  
  • 14.   Measures of Success 1.  Better health care - Improve individual patient experiences of care along the IOM 6 domains of quality: Safety, Effectiveness, Patient-Centeredness, Timeliness, Efficiency, and Equity 2.  Better health - Focus on the overall health outcomes of populations by addressing underlying causes of poor health, such as: physical inactivity, behavioral risk factors, lack of preventive care, and poor nutrition 3.  Reduced costs - Lower the total cost of care for Medicare, Medicaid and CHIP bene ciaries by improving quality of care and patient experience 14  
  • 15. Innovation Center Menu of Options Global   Pioneer     Payment   ACO  –   ACOs   ACO  –   Track  2   Track  1   Medical     Homes              Bundled  Payments  for  Care                                              Improvement   Million  Hearts     Partnership  for   Pa&ents   Meaningful     Use  
  • 16. Innovation Center Initiatives to Support Care Transformation   •  ACO Initiatives: Shared Savings Program, •  Medicaid Health Home State Plan Pioneer, Advance Payment, Learning Option Sessions •  State Demonstrations to Integrate •  Bundled Payments for Care Improvement Care for Dual Eligible Individuals •  Innovation Advisors Program •  Demonstration to Improve Quality •  Multi-Payer Advanced Primary Care of Care for Nursing Facility Practice Demonstration Residents •  Comprehensive Primary Care Initiative •  Financial Models to Support State •  Partnership for Patients Efforts to Coordinate Care for Medicare-Medicaid Enrollees •  Federally Quali ed Health Center (FQHC) Advanced Primary Care Practice •  Innovation Center Initiatives Demonstration Support Care Transformation 16  
  • 17. Accountable Care Organizations   •  Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to the Medicare patients they serve •  Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors •  When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program 17  
  • 18. ACO Types   •  Medicare offers several ACO programs, including: •  Medicare Shared Savings Program—a fee-for-service program •  Advance Payment Initiative—for certain eligible providers in the Shared Savings Program •  Pioneer ACO Model— population-based payment initiative for health care organizations and providers already experienced in coordinating care for patients across care settings 18  
  • 19. Transforming Health Care Through Active Engagement   •  No one organization or region has a monopoly on innovation •  Innovators across the country have developed other effective care delivery and payment models •  These innovations offer us pathways to building a future health system that is more effective than the current system at improving health care, health, and lowering costs 19  
  • 20. The Infrastructure Implications of Accountable Care   •  New IT infrastructure models will be required –  EMRs/Meaningful Use and health IT adoption –  Health information exchange and other •  Address challenges of care coordination and risk management at an organizational level and across potentially diverse organizations •  à Investments in data collection, integration, and analytics –  Population health management, cost analytics, risk modeling and predictive analytics •  à Investments in patient engagement –  Personal health records 20  
  • 21. Innovation Imperative   •  Success of new models predicated on our ability to innovate •  New markets are being created but there is a window for proof-of-concept •  Magnitude and velocity of our ability to innovate will be critical to our ability to implement, learn, diffuse 21  
  • 22. Introducing the Health Care Innovation Challenge •  The Innovation Center has received over 500 suggestions and ideas from across the country. •  This initiative is an open solicitation to innovators across the country to identify and test innovative service delivery/payment models including infrastructure support. •  This Challenge will strengthen the Innovation Center s current menu of options and will address unique needs of communities and populations across the country. 22  
  • 23. Challenge Objectives •  Engage a broad set of innovation partners to identify and test new care delivery and payment models that originate in the eld and improve quality while lowering the total cost of care. •  Support innovators that can rapidly deploy care improvement models within six months of the award through new ventures or expansion of existing efforts. •  Identify new models of workforce development, training and deployment that support new models either directly or through new infrastructure activities. 23  
  • 24. Challenge Area: Service/Payment Delivery Model   •  $1 billion to fund innovative service delivery and payment models to support those innovative models •  Successful proposals will –  De ne and test a clear pathway to sustainability (higher quality and lower total system cost) –  Demonstrate care improvement within six months of award –  Support care transformation with enhanced infrastructure activity –  Rapidly develop and deploy a health care workforce Proposals are encouraged to focus on high-cost/high-risk populations –  Including those with multiple chronic conditions, mental health or substance abuse issues, poor health status due to socioeconomic and environmental factors, or the frail elderly 24  
  • 25.   Challenge Area: Infrastructure Support •  New types of infrastructure will enable others to learn from and support more effective and efficient system-wide function •  Enhancing infrastructure activity is critical to fully achieving better care, better health, and lower costs •  Examples: –  Implementation of registries –  Medication reconciliation systems –  Shared-decision making systems –  Innovation or Improvement Networks –  Community collaboratives 25  
  • 26.   Challenge Area: Workforce Impact •  Transforming our health system requires transformation of our health workforce •  Need to identify and test new ways to create the workforce of the future that will deliver and support new care models. •  Examples: –  New roles and skills for existing health professionals –  New types of workers to support care transformation –  Team-based models to better utilize a mix of health providers 26  
  • 27. Challenge Area: Speed to Implementation   •  Proposed models should be operational and capable of rapid expansion or sufficiently developed to be rapidly deployed. •  Proposals will be expected to deploy care improvement models within 6 months of the award. •  Training programs are eligible for funding but should be intensive, brief programs connected to the model being tested. 27  
  • 28. Challenge Area: Pathway to Sustainability   •  Proposed models are expected to –  De ne and test a clear pathway to ongoing sustainability –  Inform future bene t design and/or payment approaches for CMS consideration and –  Provide recommendations for the scaling and diffusion of the proposed model •  Preference will be given to proposals that can achieve sustainability as soon as possible within 3 years. •  Examples of sustainability approaches: –  Public-private partnerships –  Multi-payer approaches –  Proposed service delivery agreements with entities such as ACOs or Advanced Primary Care models, mental health/public health systems 28  
  • 29. Selection Criteria   •  Model Design •  Organizational Capacity •  Workforce •  Sustainability and Finances •  Evaluation 29  
  • 30. Learning and Diffusion •  The Innovation Center will identify and diffuse successful practices that achieve better health care, better health, and lower costs •  Awardees will engage in shared learning activities designed to –  Bring organizations together to learn from one another –  Actively measure success –  Share breakthrough ideas to accelerate progress 30  
  • 31. Eligible Applicants •  Provider groups •  Public-private partnerships •  Health systems •  Private sector organizations •  Payers •  Faith-based organizations •  Community-collaboratives •  For-pro t organizations •  Community-based organizations •  Local governments 31  
  • 32. Innovation through the lenses of HITECH and Health Reform Wil Yu Director, Innovations Wil.Yu@HHS.gov HHS